Computerized Cadavers: Shades of Being and Representation in Virtual Reality

Thomas J. Csordas
Case Western Reserve University
txc9@po.cwru.edu

One way to address the question of what it means to be human is to begin with the
observation that we have a world and inhabit a world. The inquiry unfolds under its own
weight from this point, with the next set of questions necessarily having to do with how
worlds (for they are always multiple) are constituted, what it means to have them, and
precisely how we inhabit them. In contemporary society biotechnology, one of the central
concerns of the present volume, is increasingly implicated in transforming the very
bodily conditions for having and inhabiting any world. This is doubly the case when
biotechnology includes sophisticated computer applications, since computers and computer
networks are recognized as having enormous transformative potential. Indeed, Sherry
Turkle (1995) has suggested important modulations of the self are in the making, and the
philosopher Michael Heim (1993) has suggested that the computer is leading to a major
ontological shift - a modulation in the structure of human reality itself.

Elaborating the cultural consequences of biotechnology applications of the computer
with respect to the having and inhabiting of worlds requires, in my view, what can be
called a cultural phenomenology (Csordas 1990, 1994a, b). For present purposes,
the critical feature of such an approach is focus on the interplay between cultural
representations and cultural modes of being-in-the-world. Much recent cultural analysis
privileges the pole of representation, with culture understood as constituted by
symbols, signs, and images. From this standpoint, textuality is the most prominent
metaphor guiding the interpretation of culture, and the world is not so much inhabited
as represented in a way that can be read. While interpretively powerful, however, the
notion of textuality is less apt for specifying cultural modes of being-in-the-world --
that is, the the kinds of engagement and participation of humans in our worlds -- than
is the complementary notion of embodiment. This notion places us at once at the most
general and limiting condition of our existence. Our bodily existence, or embodiment, is
from this standpoint understood to have a range of potential experiential modalities in
relation to features of cultural and historical context.

The interplay between representation and being-in-the-world, and the complementarity
between textuality and embodiment, is precisely at issue in biotechnology applications
of the computer. First, the human body is the objective target of technology. By being
taken up into the technological environment it is represented and, I would suggest, has
its being-in-the-world altered. Second, the computer user is the embodied subjective
manipulator of the technology. In this capacity a person encounters representations of
the body and again, I would suggest along the lines of Turkle and Heim cited above, has
its being-in-the-world altered. The example I offer in this paper involves the use of
computer-generated virtual reality to create so-called "virtual cadavers" that are used
for purposes such as the teaching of human anatomy and in computer-assisted surgery. The
following discussion takes up these issues as they are being played out in the "Visible
Human Project," and concludes with a reflection on their consequences for embodiment
with respect to representation and being-in-the-world.

The Creation of Computerized Cadavers

The creation of the "Visible Human" cadavers was an extraordinary technological feat,
achieved with funding from the federal government. National Library of Medicine director
Donald Lindberg notes that the Visible Human Project originated with his observation in
1987 that "the medical school community needed a better way to teach anatomy." In 1991
the NLM awarded a contract for development of the proposed data set to the University of
Colorado Center for Human Simulation, with a subcontract for creation of
three-dimensional volumetric visualizations of the computerized cadavers to the
Visualization Group of the Scientific Computing Division of the National Center for
Atmospheric Research. The first step was to find a suitable cadaver, beginning with a
male. In 1993, after two and a half years of searching for a fresh cadaver that was
"'normal' and within guidelines of size and age," a qualified thirty-nine year old Texas
death row inmate named Joseph P. Jernigan agreed to donate his body to science in
exchange for being allowed to die by lethal injection rather than electrocution. This
suited the researchers' purposes well, since electrocution alters the tissues in ways
that would defeat the purpose of having as lifelike a body as possible.

The second step was creation of three matching sets of images composed of transverse
sections or "slices" of Jernigan's body. The first two sets were obtained by magnetic
resonance imaging (MRI) and computed tomography (CT). Next the body was encased in
gelatin, frozen to minus 160 degrees Fahrenheit, and cut into four sections. It was then
sectioned into 1,878 transverse slices each 1mm thick, corresponding exactly to the MRI
and CT images. High-resolution color digital photographs were taken of the block after
each slice. By the time a female cadaver - a fifty-nine year old woman who died of heart
disease and whose family insisted she remain anonymous - was subjected to the same
procedure a year later, the researchers decided they could achieve greater detail and
higher resolution by making the slices one-third the thickness. Consequently she was
sectioned into 5,189 transverse slices. For both, the MRI and CT images were created
from the whole body prior to freezing. The photographic images were of the face of each
section not as it was planed away by a custom-designed laser-guided cryogenic macrotome.
The physical remains thus became a collection of frozen shavings, which were then
cremated, such that their digital remains now have, in some yet to be understood sense
that we will explore shortly, a more concrete existence.

Each of the three types of transverse images was digitally captured at 2,048 x 2,048
x 42 bits, and aligned with its companion images and with images of adjacent slices. The
combined datasets are astronomically large: the male takes up a total of 15 gigabytes
and the female occupies 39 gigabytes. These data are stored on an FTP site, and with a
free license can be downloaded directly from the Internet. Donald Lindberg, Director of
the National Library of Medicine, states that "With the Visible Human Project, we are
returning to the idea that a library holds the knowledge of a profession - not just
reprints, journals, and books. The advent of technology gives us the opportunity to
store knowledge electronically and distribute it, virtually instantaneously, throughout
the world." A NLM project report from 1996 notes that already the Visible Human data
"are being applied to a wide range of educational, diagnostic, treatment planning,
virtual reality, artistic, mathematical, and industrial uses," and by the end of the
year over 700 licenses had been issued to users in 27 countries.

Let us explore the capabilities of the two virtual cadavers for producing computer
images of the human body. The basic form is the transverse section (each in its own
computer file), but because the images are precisely aligned, it is possible as well to
produce vertical and horizontal sections through virtually any plane. More sophisticated
programs are able to produce three-dimensional representations by stacking slices and
isolating sites corresponding to particular internal or external anatomical structures.
For example, the accompanying male and female heads, generated by William Lorenson of
the General Electric Corporation, are not photographs but reconstructions of surface
features from the slices (215 physical slices for the male, 209 CT slices for the
female). Manipulating and combining these images using state-of-the-art visualization
programs makes it possible to penetrate the body - giving the sense of walking or flying
through (as in walking through walls, or superhero "x-ray vision"). Different levels of
depth or systems (skin, muscles, skeleton) can be superimposed to be viewed
simultaneously, and discrete anatomical structures can be isolated. Further, these
images can be rotated to be viewed from different perspectives, not only in successive
still images but in computer animations. Currently these have advanced to the point of
allowing surgical simulations - to be discussed in somewhat more detail below - similar
to flight simulations used in training pilots. In one easily available demonstration
from the Center for Human Simulation, one can watch a computerized scalpel make an
incision in a thigh sliced off from the body above and below the knee, the incision
gradually opening to reveal muscle and fat, and the section then rotating in mid-screen
and moving to a closeup to show several views of the incision. Developers of these
methods promise that their animations - one is tempted to say reanimations - will
eventually include blood coursing through veins and around organs, and breath pulsing
through lungs. Beyond that is the prospect of transformations that will simulate the
processes of aging (as well as, of course, growing young again) and pathology (as well
as its reversal). All this in the context of the technical aspiration to render future
candidates into ever thinner slices to enter into ever larger databases. One can imagine
a race of reanimated virtual cadavers faithful to their human form to the cellular
level, infinitely mutable, able to be subject to many simultaneous surgical procedures
and healing processes, capable of reanimation and regeneration in whole or in any part.

Simuloids, Avatars, and Shades

Virtual cadavers are phenomena in and of cyberspace and virtual reality. Let me
clarify my understanding of how these terms are related. A person who sends E-mail or
peruses sites on the World Wide Web is tapping into cyberspace, but not in a strong
sense entering a virtual reality. Here the computer is a communicative tool, a
cybernetic enhancement of mail and media. A person outfitted with data glove and data
goggles involved in an advanced computerized simulation is entering a virtual reality,
but is not in cyberspace. Here the computer is an aesthetic tool, a cybernetic
enhancement of dramatic and performative techniques by which we create imaginative
terrains. To put it more formulaically, cyberspace is an intersubjective medium
constituted socially (constituted by interaction among participants in the communicative
medium), while virtual reality is the subjective sensory presence in that medium
(constituted by interaction between individual user and technology). The intersection of
the two is full sensory and bodily engagement in a virtual reality that is also fully
networked and plugged into cyberspace - in other words, the full blown, Gibsonesque,
science fiction version of virtual reality within cyberspace. This intersection is
important to identify because, I would argue, it is precisely the cultural locus of the
virtual cadavers.

What do we mean by "cultural locus" in this instance? Let us accept the metaphor of
cyberspace with sufficient literalness to conceive it not as a "cultural domain," but as
a distinct "ethnographic terrain," so that it is legitimate to talk about an ethnography
of cyberspace. Indeed, there has very recently been a florescence of work along these
lines in anthropology, and the number of sessions devoted to related topics at the last
several meetings of the American Anthropological Association indicate a groundswell of
interest. The most prominent concept in this area is that of "virtual communities," or
networks of social interaction with fluid boundaries and varying degrees of apparent
permanence, composed of actors whose agency is expanded to the point of controlling and
manipulating their own identities as pure forms of representation, and who interact with
ambiguous others whose identities are never certain. While there is thus a clearly
articulated concern with the kind of relationships that exist in cyberspace, taking the
metaphor of cyberspace literally as an ethnographic terrain allows us to formulate a
parallel concern with the kind of beings that inhabit cyberspace. We can then propose a
preliminary inventory of such beings, with the caveat that the "cyborg" is not among
them, for a cyborg is by definition a creature of the technological interface. We are
cyborgs whenever our bodily capacities are technologically altered or enhanced,
including when we have our noses pressed up against the window of cyberspace by virtue
of booting up. The goal here is an inventory of beings that exist wholly on the hither
side of the interface, in the ethnographic terrain marked by what we just now identified
as the intersection of cyberspace and virtual reality.

Accordingly, my preliminary inventory consists of three types of beings: simuloids,
avatars, and shades. Simuloids are software-generated entities that have no sentient
counterpart in actuality. In the language of the industry, these are referred to
variously as humanoid technologies, virtual humans, human-modeling systems,
computer-generated humanoids, or autonomous creatures. Simuloids are described as
"autonomous" not in the sense that they have agency in their own right but in the sense
that they are independent of human agency: they are software-controlled rather than
human-controlled. They are also autonomous from any necessity to conform to concrete
actuality, and thus their features may transcend the human - they can as easily be
animal, machine, or monster. However, a great deal of attention is currently being
devoted to the development of virtual humans per se, defined as "computer-generated
people that live, work and play in virtual worlds, standing in for real individuals or
carrying out jobs that real people cannot do." The news service story that carries this
definition also quotes Sandra Kay Helsel, editor of VR News, as pronouncing that
"Virtual Humans will be the growth industry of the 1990s!" Characters in computer games
are simuloids, as are the characters Max Headroom, the computer HAL from the film "2001,
A Space Odyssey," and the villainous cyberman in the movie "Virtuosity." The most
advanced simuloids include the virtual humans developed by Nadia Thalmann with her
"Marilyn" program that can simulate Marilyn Monroe and Humphrey Bogart as well, and
includes characteristics such as emotional expression, speech, clothes, hair, and the
ability to respond to computer users. Norman Badler's "Jack" system of human modeling is
based on a figure designed to the specifications of the average American male that is
capable of articulated motion including balance modification and collision avoidance,
gesture and facial expressions, natural language processing, and transformation in size
and color.

The term avatar is already in popular usage, and is sometimes applied to what I have
called simuloids, but I want to restrict its meaning to virtual incarnations of human
actors on the hither side of the interface that are directly controlled by those actors.
It is worth playing out some of the cultural connotations of the notion of avatar
because of the implications regarding self, agency, and being that can be read into it.
The primary meaning of the term, of course is the incarnation of a Hindu deity in actual
human form. By extension, on the one hand the human computer operator is analogous to a
kind of deity that manipulates the computerized avatar in virtual human form. On the
other hand, the extension inverts the meaning of the Sanskrit term in a subtle way:
whereas the Hindu avatar is an incarnation of a deity into an earthly form, the computer
avatar is a virtual apotheosis of an earthly being into an imaginative realm of
fantastic powers and shape-shifting. A more secularized use of the term offered by
Webster's dictionary suggest that an avatar can be an embodiment, as of a concept or
philosophy, usually in human form, a definition which prompts the observation that what
is being embodied by the computer avatar is the human form itself.

Another, more thoroughly abstracted definition from Webster's has the avatar as "a
variant phase or version of a continuing basic entity." This one prompts the question of
whether the avatar is best considered a representation of a person, a cybernetic
extension of the person, a projection of a person into cyberspace, or indeed a "variant
phase or version" of a person, for

certainly the avatar is much more than a computerized double or simulation programmed
to act like a person. Indeed, in February 1996 a virtual wedding took place in Los
Angeles in which vows were exchanged on-screen via avatars while the participants
remained in separate geographical locations in actuality. What varies from a technical
standpoint is the degree of sensory engagement of operator in avatar. In practice,
avatars can be imagined forms described to other users by typing in text, as in the
interactive computer sex networks where people become animals or creatures endowed with
the most amazing and creative types of sexual organs and multiple genders. Avatars can
also be visual "body icons" that can be manipulated and come into the virtual presence
of the body icons of other users, but are now often little more than "grim-looking
peg-doll shapes" lacking faces or feet. The most advanced include multisensory feedback
in which it is experientially the case that the avatars are not so much representations
of the user as projections of the user into virtual space. Such projections are
themselves customized computer-generated forms, but may in principle also be
computer-animated video images as is pioneered in the "synthespian" technology developed
by Jeff Kleiser and Diana Waczak.

To summarize the distinction between types of beings that I've drawn here,
"simuloids" are computer-generated stand-ins for people with no connection to any actual
person, while "avatars" are projections of living people as digitized persons. To draw
on vivid popular-culture examples, the computer-generated villain of the movie
"Virtuosity" is a simuloid that crosses the interface from virtuality into actuality and
becomes embodied; the character Jobe in the movie "Lawnmower Man" is a human who crosses
from actuality into virtuality to literally become his avatar and abandon his body. The
purpose of this contrast is to introduce what is quite a distinct third type of being
indigenous to cyberspace. The computerized virtual cadavers produced by the Visible
Human Project of the National Library of Medicine are what I'll call "shades," derived
from the use of that word to refer to a spirit in the netherworld. There are only two
such beings at present, a male and a female, but their existence has profound
consequences that we are just now barely beginning to work out. These shades are "in"
cyberspace and virtual reality in a sense distinct from either simuloids or avatars.
Like a simuloid, the shade can operate as a stand-in for a person, but unlike a simuloid
it is a distillation of an actual person that can be digitally superimposed on another
actual person. Like an avatar, the shade is a projection of a real person into
cyberspace, but unlike an avatar that person is not only dead but has been dissolved as
a physical being. It thus exists solely on the hither side of the interface, where it is
not an animation but a reanimation - a new kind of being entirely. Let us elaborate this
analysis by briefly examining the biotechnological and symbolic structure of shades.

Adam and Eve in the Virtual World of the Dead

When the first images of the Visible Human male were presented, the regents of the
NLM broke out in spontaneous applause, prompting a comment by project director Ackerman
quoted by the Denver Post: "It was sort of like applauding at the end of a movement in a
concert. It was inappropriate, and the decorum is not that way. But it was a clear
indication of how excited people are." Given the excitement generated by this
biotechnological juggernaut, let us pose the following question: what is the relation
between Joseph Jernigan, the housewife from Maryland, and the datasets they have become?
In other words, what constitutes their cultural status (being) as shades? For a
preliminary answer I take as data representations of the event in newsletters of the
National Library of Medicine and approximately 55 articles from the popular media.

One way of thinking about the change in cultural status is most evident with
Jernigan, whose fate was the more public. Here there is a sense of "through the looking
glass" with respect to representation of his personhood. The first mention of Jernigan
is in retrospect rather eerily incognizant of his subsequent posthumous celebrity. It is
a typical article furnished by Reuters in the NYT of August 6th, 1993 reporting that he
was executed by lethal injection after having admitted to killing a homeowner who
surprised him during a burglary. Such deaths by execution are routinely reported in the
news media, and the article's significance does not go beyond the observation that
because the reinstitutionalization of capital punishment in the United States remains at
least a back-burner issue of public discussion, executions remain newsworthy. By April
of 1994 his previous existence was a distorted footnote. A bylined article on the
forthcoming release of the Visible Human Male data set picked up by several
Knight-Ridder papers described the cadaver as a "drug overdose victim" (this incredibly
bad article also referred to the film "Fantastic Voyage" as "Incredible Journey."), as
did articles in 1994 and 1995 in the Denver Post. The Denver Post in 1994
mentions the project in an article on "cryonics," the practice of freezing dead diseased
individuals in hopes of bringing them back to life when medical technology has advanced
sufficiently to cure them, with the concluding comment that "the project doesn't aim to
revive the subjects." Nevertheless one is left with the titillating image of a person,
whose personal identity is rather beside the point, who is in some sense capable of
being reanimated.

The sense of "through the looking glass" that defines the cultural status of shades
is most evident in a series of metaphors invoked to describe them. There are four sets
of metaphors, one describing the shades as Adam and Eve, one in images of birth or
immortality, another as they are a virtual terrain to be mapped, and one that invokes
Leonardo da Vinci. The Adam and Eve metaphor is doubtless the most symbolically charged.
This is evident in that it was the original intent of the project directors to use these
as the formal titles for their shades instead of the markedly more awkward "Visible
Human Male" and Visible Human Female." The plan had to be abandoned in the face of
threatened legal conflict with a company that had already named itself and its
interactive anatomy software program "A.D.A.M.," an acronym for Animated Dissection of
Anatomy for Medicine. The competition - never mind that the A.D.A.M. company is now
itself licensed to use the Visible Human shades in its product development - indicates
that something rather existential might indeed be at stake in the advent of shades.

A sampler of these metaphors will give a flavor of what I mean. The Philadelphia
Inquirer (4/14/94) refers to the shades as a "'perfect couple' -- an Adam and Eve for
computer immortality." The Denver Post (6/6/94) calls them the "first couple," the
Baltimore Sun (11/29/95) announces that the female shade is a "Partner for 'Visible
Man,'" and the Times (11/29/94) reports that NLM was "on the look-out for a female donor
to share his life on the wire." The Economist (3/5/94) goes yet further in its reference
to "A new family -- Adam, Eve, and their embryonic offspring," pairing the Visible
Humans with the Visible Embryo Project at the Armed Forces Institute of Pathology .
Elsewhere in the piece they are referred to as "Adam, Eve, and little Cain," and the
National Library of Medicine as their "electronic Garden of Eden." Referring to plans to
increase the inventory of shades, the San Diego Union-Tribune 3/15/95 notes that "The
future might also bring Visible progeny, Grandpa and Grandma, or a younger
pre-menopausal woman."

The Adam and Eve metaphor cannot be written off as either tritely cute or
opportunistically commercial - the metaphor is simply too good a fit with contemporary
gender symbolism (see also Treichler 1998). Although there was no more of a relation
between Jernigan and the Maryland housewife than between any two cadavers donated to
medical research, there is evident appeal in transforming them into a mythical first
couple in a new virtual world, digitally reanimated and capable of necrosexual
procreation of a family or species of shades. Conveniently, this time around Adam and
Eve are both white. Naturally the male was created first, and the female second, though
this time not from Adam's rib. As is the case generally in contemporary society, the
male is guaranteed an identity (though fortuitously because his cause of death was
public, court-ordered), while the female remains anonymous (though on the hither side of
the looking-glass that anonymity was understood as a right). The image of Adam rendered
in 1mm slices is rougher, while Eve is more refined or, in a pun spun by one journalist,
she "looks sharper" than her male counterpart. Stated otherwise, in the Foucauldian
idiom of bodily surveillance, if the male can be scrutinized the female can be
scrutinized more thoroughly. The male was an evil victimizer killed by lethal injection,
the woman was an innocent victim who died of a heart (as in "bless her heart") attack.
Adam is sufficient in his own right, indeed a magnificent specimen who pumped iron,
while word is that Eve needs to be supplemented by pre-menopausal counterpart - we can
expect polygyny in cyberspace.

The second set of metaphors has to do with birth and immortality. On the one hand, a
1996 World Wide Web self-description of the UCHSC Center for Human Simulation by its
staff observed that their anatomical imaging laboratory has "given birth to the Visible
Human - Male and Female," while the Times (11/29/94) reported "Executed killer reborn as
'visible man' in Internet." On the other hand, the National Library of Medicine
newsletter (1995:50:6) reported that the visible humans are "immortalized on the
Internet." The Independent (11/29/94) announced that "A killer was yesterday let loose
on the Internet computer network," and NetGuide magazine (4/1/95) that "A killer... has
been immortalized..." Life Magazine (2/97) refers to "electronic afterlife," the
Baltimore Sun (11/29/95) stated that the shade "...has won a measure of computerized
immortality," and the Denver Post (6/6/94) that the project "promises eternal life for
the participants." These metaphors are neither idle nor contradictory, but reflect views
from different sides of the looking glass. The humans are in a sense immortal in their
new form, their shades are in a sense born again beings of a new space.

Two rather less developed metaphors that yet indicate something of the cultural
status of shades can be identified. One is the elevation of the shades in a celebration
of the human form that places them alongside the renderings of Leonardo. A group at
University Hospital in Hamburg, Germany that has developed an impressive 3D Atlas called
VoxelMan draws a direct historical line from Leonardo to the development of x-rays, on
to the invention of CT and MRI technology, and thence to the Visible Humans. A group of
artists in Japan is explicitly juxtaposing Leonardo's representations with
representations of the Visible Human shades. Implicit is the ideal of approaching
reality via virtuality, a connotation that is also evident in the slightly jarring
phrase of the Baltimore Sun (11/29/95) referring to "real bodies on a computer."

The final image, which I found only once in a quote from one of the project
coordinators, is telling in its appeal to the inanimate. This was in a reference by
project director Ackerman to the need to label each site and segment of the Visible
Humans, since "Right now, looking at them is like looking at a road map with no street
names." Here the shades are understood as a terrain to be traversed - not an unknown
virgin territory, but a map not yet useful because not yet labeled.

Taken together, I would suggest that these sets of metaphors disclose the workings of
a deep essentialism that constitutes the cultural status of shades. The Adam and Eve
metaphors point to gender essences defined by the heterosexual reproductive couple - the
two shades could have been defined as siblings, or even, given their age difference, as
mother and son. The immortality metaphors define a moral essence, whether conceived as
an untainted being prior to the Fall or to a redeemed being in the guise of a born-again
convict. The Leonardo metaphor outlines an aesthetic essence of the apotheosized ideal
man - notably without female counterpart. The map metaphor implies a cosmic essence by
assimilating the body to a terrain, but in particular one that still needs to be
charted. The positing of essences in these popular metaphors is implicitly a strategy of
identity, made all the more compelling by two features. First, positing the essence of
the other (the not-me, the shade) is a double-edged act of self-definition either by
denial (me as the opposite of not-me) or by desire (the wished-for me). Second, the
force of this double-edgedness is enhanced by the paradoxical condition of the shades as
virtuality in actuality, their apparent existence as "real bodies on the Internet." But
how can all this be so?

The Meaning of Metaphor: Virtual or Actual?

Two methodological points can help assess the consequences of the foregoing
discussion of popular metaphors. First, the discussion assumes that such metaphors offer
an interpretive opening to cultural meaning. The analysis can only be valid, for
example, if the metaphoric description of the first shades as "Adam and Eve" is accepted
as nontrivial, more than an eye-catching journalistic ploy. It was certainly common
enough - only the sober British Daily Telegraph consistently reported on the
project without recourse to metaphor. Once accepted, this assumption allows the
implications of the metaphors to be spun out and regarded as data about the "cultural
imaginary," which is further assumed to be as consequential as what we could call the
"culturally literal," that is the language of technology and its application. In this
context, the cultural imaginary is the realm of possibility, desire, and fear in which
we participate passively insofar as it lurks anxiously beneath conscious awareness
(compare Ragland-Sullivan 1986: 138-62 on Lacan's notion of the imaginary) and in which
we participate actively by the exercise of imagination, the "capacity to articulate what
used to be separate...which allows one either to make a new move or change the rules of
the game" (Lyotard 1984: 52). Looking at a text from the standpoint of the culturally
literal, one could argue that a metaphor is only a colorful analogy to help clarify an
objective relation or function - the metaphor is discursively subordinate to the
function. Regarding metaphor as an opening into the cultural imaginary grants it a far
more important role, one in which the cultural imaginary has an equivalent status with -
indeed is in a dialectical relation with - the culturally literal. From the glass half
full perspective this dialectic is one in which they mutually constitute one another.
From the glass half empty perspective it is one in which they mutually destabilize one
another. At the very least, one could say that the cultural imaginary provides the
context by means of which the existential implications of the technical innovation can
be examined, while the culturally literal leaves discussion at the level of policy
implications.

The second point is the importance of identifying the social origins and destinations
of the cultural meanings that are spun into the gossamer fabric of a cultural imaginary.
In the case of computerized cadavers, the sense-making process that accompanies the
technological development originates principally from the Visible Human Project
coordinators, from groups developing project applications, and from public media that
disseminate information about the project. A fourth source is the metadiscourse of
cultural analysts - we must reflexively include, for example, the metaphorical offering
of "shades" to define the computerized cadavers. Members of each group participate both
passively and actively in the cultural imaginary, but each has a socially positioned
take on the relation between the cultural imaginary and cultural literality. The appeal
to the literal through the use of technical and policy language is given greater or
lesser weight by project coordinators whose audience is government funding sources,
potential database users, and the media; developers of application whose audience is a
potential market for those applications; the media whose audience is the general public;
and cultural analysts whose audience is academia. Each is thoroughly ensconced in the
dialectic between imaginary and literal, and that dialectic is constituted by the sum of
their social positionalities.

This understanding of the relation between the cultural imaginary and the culturally
literal remains somewhat strained unless it takes into account what I regard as an
orthogonal distinction between representation and being-in-the-world. Cultural analysis
will always be subject to suspicions of whether it is dealing with reality if it is cast
entirely in terms of representation, or analysis of representation. The popular
metaphors surrounding the Visible Human shades, and the images themselves, are
necessarily of limited consequence if they are analyzed on the representational level
alone. The metaphors are indeed frivolous unless they are interpreted as hinting at or
disclosing a subtle shift in our mode of being-in-the-world, and the remarkable images
with all their combinatorial possibilities bear no more intimate connection to the
original people-cum-cadavers than a photograph torn up and taped together again unless
they do the same. My intent in introducing the notion of a "shade" is to push us into
thinking beyond representation and toward being.

Yet when dealing with such a general notion as being, it is important to think
globally in order to avoid essentializing a cultural particularity. Thus the disposition
of the actual bodies might not appear much more radical to a North American than that of
a medical cadaver or a cremated dead person. Consider the integrity of being required in
a Buddhist society like Japan, where one cannot take one's place among the ancestors or
expect a higher reincarnation if one goes to the grave lacking a part of one's body.
From that standpoint, would one react with complaisance regarding the moral import of
creating shades? Final cremation aside, what might be the cosmological status of a human
who has been ground into dust? On the other side of the existential looking-glass, once
transformed into a shade, what might be the status of one who can be divided into chunks
repeatedly? On a more mundanely North American ethical level, what about anonymity and
privacy? A conventional cadaver used in anatomy training is both anonymous and lacks
identity. A shade is not anonymous, for even the woman from Maryland might be recognized
by an acquaintance who saw her reconstituted visage. Project director Ackerman has said
"We're hopeful that if she is recognizable, that people will respect her anonymity.
There is nothing we can do" that wouldn't compromise the data (Baltimore Sun 11/29/95).
Moreover, a shade retains identity, for even Jernigan at least in some sense remains who
he was whether or not he comes to be called "Adam" instead of Joseph.

All things considered, the argument about the being of shades would remain rather
disingenuous if we were not clear that the primary concern was our own being in relation
to them, or in other words how the technological innovation induces a subtle modulation
in our own embodiment and hence in our own culturally situated being-in-the-world.
Subjectivity and intersubjectivity are bodily phenomena, and thus the question becomes
the potential transformation of subjectivity on the part of those who use the
technology, and especially with regard to physicians, in the intersubjective relation
formed with those bodily being who are their patients. In this light, let us briefly
consider the two most immediate sites of impact, namely anatomy training for medical
students, and computer-aided surgery.

"It Empowers Us"

At the fourth annual conference on "Medicine and Virtual Reality" in January of 1996,
Michael Ackerman and Victor Spitzer, director of the project at NLM and director of the
contracting group at UCHSC, received the Satava Award, named for Col. Richard Satava, a
pioneer in VR telesurgery. Helene Hoffman, herself director of the anatomy curriculum
using Visible Human data at UCSD medical school, observed that "This data set has become
the new standard for human physiology education. For example, 30 to 40% of the papers
presented at this year's conference alone relied on this data set." A variety of medical
schools are actively developing anatomy curricula based on Visible Human data. The
primary debate is over whether these methods are to be used to complement or to replace
conventional dissection in anatomy education. Traditionalists are resistant to the idea
that medical students would not have the hands on experience of work with real bodies in
what is implicitly sacrosanct as a rite of passage in medical training. Innovators point
out that actual cadavers are increasingly short in supply in comparison to the
infinitely reusable shades, and that in any case most physicians other than surgeons
will never have occasion to work on the insides of their patients.

The potential consequences with respect to embodiment for both medical students and
their future patients must be understood with respect to the already profound
phenomenological transformation wrought in conventional training. In his ethnographic
study of medical students, the anthropologist Byron Good has observed that the
dimensions of the world of experience built up in their training were "more profoundly
different from my everyday world than nearly any of those I have experienced in other
field research" (1994:71). Reminiscent of the map without street signs metaphor I
mentioned above, students learning anatomy are "as geographers moving from gross
topography to the detail of microecology" (1994: 72). Good repeatedly refers to the
intimacy with which medical students come to know the body, and describes the anatomy
lab as a kind of ritual space in which the reconstitution of experience takes place. The
accustomed body surfaces that define personhood are drawn back, revealing an "interior"
that consists not of a person's inner emotional life but a complex three-dimensional
space with planes of tissue that are separated to distinguish the boundaries of gross
forms and fine structures. As one student said, "Emotionally a leg has such a different
meaning after you get the skin off" (1994: 72). The new way of seeing beneath the
surface that is central to the medical gaze can usually be turned on and off, but also
bleeds over into the student's everyday perception of other persons, as they are
constituted and reconstituted - translated and retranslated - between the perceptual
languages of medicine and everyday life. Good observes that this training is profoundly
visual, and the profundity of phenomenological transformation can only be enhanced by
the new anatomy curricula based on virtual reality. The penetration to increasingly
minute levels of biological hierarchy (epidemiological - clinical - histological -
cellular - molecular/genetic) will be complemented by a penetration based on
transparency, the sense of "x-ray vision."

A preliminary glimpse of the potential change comes from a reflection by a medical
student who attended the introduction of the Visible Human Female in 1995. Referring to
the Visible human as a prime example of high performance computing as applied to
biomedical science, he writes "It empowers us. We students know that a world of
information is out there at the touch of our fingertips" (Roberts 1996). He was
impressed by the fact that brain sections would not fall apart as they sometimes do in
dissection of a real cadaver, that one can isolate sections of the body rather than
"deal with the whole daunting thing," that the circulatory system would appear like a
real 3D loop rather than flat as in a textbook, that the database could be reformatted
to change body characteristics, that the images could be rotated, dissected, and
resected, and that some day he would be able to call up these images in his offices to
help educate patients about illnesses and procedures.

Several questions arise concerning the ultimate experiential consequences of applying
this technology. What will be the consequences of isolating body parts for detailed,
intensive work? Will it enhance the sense of intimacy noted by Good or will it initiate
a more fragmented, objectified sense of the body? What will be the consequences of
digital dissection that is both exceedingly neat and comfortably reversible in
comparison to actual dissection, in much the way word processing allows easy deletion
and substitution in comparison to writing or typing? Will it introduce a sense of
arbitrariness of biological process, or enhance the understanding of meticulous detail?
Finally, what will be the consequence of empowerment as it is alluded to by the medical
student rapporteur. Will it be the power of humanizing intimacy and compassion, or that
of apotheosizing omnipotence and objectification of one's fellow beings? Will it refine
the sensibilities of physicians as a flower blossom unfolding to reveal its intimate
recesses rather than having to be sliced open or peeled apart petal by petal?

"From Blood and Guts to Bits and Bytes"

Beyond the training of medical students, shades will increasingly play a role in the
development of surgical training and what is called "telepresence surgery." The title of
this section is a favorite phrase of Col. Richard Satava, M.D., one of the leading
figures in this area, in referring to a major paradigm shift in which the blood and guts
of conventional surgery is replaced by the bits and bytes that will facilitate the work
of a new generation of "digital physicians" and "Nintendo surgeons." Virtual reality
surgical simulations are already available for prostrate, eye, leg, and cholycystectomy
procedures. Telepresence surgery allows the physician to project himself or herself to a
remote location via video and audio monitors, with computer-controlled instruments
controlled from the remote site with dummy handles able to provide "force feedback" that
gives the surgeon - or surgeons collaborating by network from different geographical
locations - a sense of tactile immediacy.

Satava distinguishes between artificial and natural virtual reality, the former
completely synthetic and imaginary as in the simulation of being inside a molecule, the
latter a situation that could physically exist as in surgery on a realistic recreation
of a human body (1992: 360-61). Both surgical simulation and telepresence surgery are
forms of natural virtual reality, though obviously only the latter is performed on
actual patients. Yet Satava says that "the day may come when it would not be possible to
determine if an operation were being performed on a real or computer generated
patient... the threshold has been crossed; and a new world is forming, half real and
half virtual" (1992: 363). He and his colleagues are working on just such a system, in
which the operator can fly around the organs and travel through the digestive system
(Key Words: 935), and use of shade data is allowing them to move from a cartoon-like
visual display to an increasingly life-like one. Likewise, the overlay and enhancement
of live CT/MRI data with shade data promises to augment the vividness of telepresence
surgery, as the immediacy of the electronic image and remote manipulation come to
"dissolve time and space" (Key words:939).

The development of shade-enhanced telepresence surgery has consequences for
embodiment with respect to the skills it requires of the surgeon - as what Marcel Mauss
(1950) called a "technique of the body" - and with respect to its applications on the
bodies of patients. With respect to the former, the emerging field of "Human Interface
Technology" dictates that a system have sensory intuitiveness - that it "should feel and
be used as naturally as possible." As Satava observes, telepresence surgery has the same
eye-hand axis as open surgery insofar as the surgeon looks down at a monitor, thus
preserving the correspondence of visual with proprioceptive and kinesthetic senses.
Contemporary laparoscopy requires visually looking up at a video monitor, while surgical
simulation requires wearing a virtual-reality helmet such that the surgeon must learn
the tool rather than the tool accomodating the surgeon (1994: 819-20). With respect to
patient care, the new technology will allow comparing normal and abnormal organs by
substituting images, simulating the biomechanics of muscles and joints to make more
effective replacment joints, demonstrating projected treatment courses for patients.
Military applications - one of Colonel Satava's ultimate interests - of shade-enhanced
simulation would include plotting the path of a bullet before treating a bullet wound,
and applications of telepresence surgery would include "to metaphorically project a
surgeon into every foxhole" (n.d.:12)

At least two questions are posed by these developments. The first comes from
considering that both surgical simulation and telepresence surgery pose a paradox of
simultaneously increased remoteness and enhanced intimacy. Simulation is remote from
living persons and telesurgery is geographically remote; both partake of the intimacy
afforded by the technologically enhanced medical gaze. What will be the consequences of
this paradox, and what the limits of access to the inner recesses of biological process?
The second question arises in considering Drew Leder's analysis of the typical
disappearance of the body from awareness in everyday life as it "not only projects
outward in experience but falls back into unexperiencable depths" (1990: 53). Leder
argues that it is the body's own structure that leads to its self-concealment and to a
notion of the immateriality of mind and thought that is reified as mind-body dualism.
Could it be on the culture-technological horizon that shade-enhanced virtual reality
will make the intimate core of bodily processes accessible in a new way, offering the
possibility of transcending this Cartesianism of the natural attitude?

Frozen Representation and Virtual Being-in-the-World

I want to return to the broader question of the cultural significance of shades not
in terms of the relation between the cultural imaginary and cultural practice, but in
terms of the relation between representation and being-in-the-world. The notion of
representation holds a virtual hegemony over contemporary cultural analysis, hand in
hand with the associated methodological metaphor of textuality. This extends to cultural
analysis of the body, so that scholarly works are filled with phrases like the body as
text, writing on the body, bodies of writing, the inscription of meaning on/in the body,
representations of the body, reading the body. A less prominently articulated tradition
understands culture from the standpoint of embodiment as our fundamental and culturally
conditional mode of being-in-the-world. As bodily beings we inhabit the world in terms
of the space and extension of our bodies, we engage in movement and experience
resistance to that movement, we incorporate and explore the world via our senses, we
interact with others or find ourselves in solitude. The modes of representation and
being-in-the-world are intimately intertwined in practice, for example in the way their
relation can be superimposed on the relation between subject and object: if the body is
conceived as an object, representations of the body are the site of subjectivity; if the
body is conceived as subject, representations are objectifications of the body.

I would argue that understanding the interaction between the body as representation
and the body as being-in-the-world is critical to cultural analysis in general (see
Csordas 1994b), and furthermore that this interaction defines the cultural process that
is critically at stake in the existential analysis of the shades created by the Visible
Human Project. From the standpoint of Jernigan and the Maryland housewife, are their
shades no more than hypertext versions of a photographic representation, no more
connected to their particular essences than a snapshot that could be torn to bits then
reassembled with tape and glue? Or is there something of the transformation of quantity
into quality in the degree of specificity with which their physical beings have been
digitalized, some way in which they have gone "through the looking glass?"

Indeed, it is possible to indulge a debate about whether even a simple photograph
captures something essential about a person (and anthropologists know that in some
societies this is thought quite literally to be so), or is better understood as an
arbitrary and momentary simulation that can be repeated without limit to the ultimate
degradation of meaning, similar to what might happen to the meaning of the word "egg" if
it is repeated a hundred times. However, the question of the shades' being-in-the-world
in itself is academic insofar as, the tool of science fiction placed aside, there is no
question of personal subjectivity for them. What is all the more at issue is the
subjectivity of the rest of us - specialist medical students and surgeons to be sure,
but also the coming generation. Indeed, UCHSC's Spitzer has said "I think in the future,
kids will grow up with him" (certainly an improvement on Barney). More importantly,
while by the same token there is no question of defining intersubjectivity between
shades and users, there is all the more a question of how, given the premise that
intersubjectivity is also grounded in our bodily being, it may become transformed,
enhanced, or distorted by the existence and application of shades. What will
interpersonal relations be like when I can casually visualize your skeleton as we
converse, and you can feel your way around inside my brain?

Finally, if the biotechnological innovations in virtual reality of which shades are
only one example are indeed pointing toward a modulation of embodiment, it may be so
only because of the historical condition in which culture now exists. Daniel Boorstin
wrote in 1961 that the contemporary world is already one "where fantasy is more real
than reality, where the image has more dignity than its original. We hardly dare face
our bewilderment, because the solace of belief in contrived reality is so thoroughly
real" (quoted in Kearney 1988: 252). This is to say that what we are describing is not a
technological determinism of embodiment, but a highly specific way of incorporating a
technological development into the postmodern condition of culture. Understanding this
process will require a cultural phenomenology that can capture the essence of the
particular in an embodiment constituted in the existential space between virtual and
actual, between the cultural imaginary and culturally literal, between remoteness and
intimacy, and between representation and being-in-the-world.

Notes

1. Among these are the University of California at San Diego Medical School, Loyola
University Stritch School of Medicine, Johns Hopkins in collaboration with the National
University of Singapore, SUNY Stony Brook, University of Pennsylvania Medical Center,
Washington University Medical School, the University of Chicago in collaboration with
Argonne National Laboratory, Columbia University Medical School in collaboration with
the Stephens Institute of Technology. Outside the United States, projects are underway
at the University of Hamburg School of Medicine, the Keio University School of Medicine
in Tokyo, Australian National University, and the Queensland University of Technology.

2. Visible human images presented here are available on the Internet at the following
addresses: General Electric (http://www.crd.ge.com/esl/cgsp/projects), UC San Diego
(http://cybermed.ucsd.edu), and University of Hamburg (http://www.uke.uni-hamburg.de).
Each of these can be accessed via the National Library of Medicine
(http://www.nlm.nih.gov). An impressive array of images based on the Visible Human can
be found in Tsiaras 1997.